Journal of neurotrauma最新文献

{"title":"Symptom Trajectories and Their Biopsychosocial Correlates in Pediatric Concussion: An A-CAP Study.","authors":"Keith Owen Yeates, Ken Tang, Cherri Zhang, Miriam H Beauchamp, William R Craig, Quynh Doan, Stephen B Freedman, Jocelyn Gravel, Ashley L Ware, Roger L Zemek","doi":"10.1177/08977151251365530","DOIUrl":"https://doi.org/10.1177/08977151251365530","url":null,"abstract":"<p><p>This study sought to identify trajectories of symptom status in children and adolescents with concussion across the first 6 months post-injury and to examine their biopsychosocial correlates. The study used data collected as part of a prospective, longitudinal cohort study, Advancing Concussion Assessment in Pediatrics (A-CAP), conducted from 2016 to 2019, which recruited 967 English- or French-speaking children 8.0 to <17 years old with either a concussion (<i>N</i> = 633) or mild orthopedic injury (OI; <i>N</i> = 334) from five pediatric emergency departments (EDs) in Canada. Participants rated post-injury symptoms weekly from 1 week to 3 months and biweekly from 3 to 6 months post-injury. The ratings of children with concussion were classified as symptomatic/asymptomatic relative to retrospective pre-injury symptom ratings using reliable change equations derived from the OI group. A set of 26 biopsychosocial variables, assessed in the ED or at a 1-week visit, was derived from core measures collected in the A-CAP study. They were grouped <i>a priori</i> into clusters of five to seven variables representing four domains (i.e., social determinants of health [SDoH], neurobiological, child psychosocial, and parent/family psychosocial). Symptom trajectories were examined using latent class growth analysis (LCGA). Multinomial logistic regression tested the independent and joint ability of the variables in the four domains to discriminate trajectories. Multiple imputation with chained equations was completed prior to multivariable analyses. Analyses included children with concussion with ≥1 post-injury symptom rating (<i>N</i> = 553; age <i>m</i> = 12.4 years, standard deviation = 2.5; 40.3% female). Based on multiple statistical criteria, as well as parsimony and interpretability, LCGA identified four distinct symptom trajectories: rapid recovery (<i>n</i> = 301, 54%); typical recovery (<i>n</i> = 106, 19%); slow recovery (<i>n</i> = 73, 13%); and chronically symptomatic (<i>n</i> = 73, 13%). Variables in the SDoH, neurobiological, and child psychosocial domains independently discriminated the trajectories (polytomous discrimination index [PDI] = 0.39-0.44). When combined, significant variables from those three domains showed the best overall discrimination (PDI = 0.49). The findings indicate that children with concussion display distinct symptom trajectories that differ on SDoH, neurobiological, and psychosocial variables, confirming that a biopsychosocial model is critical to understanding pediatric concussion recovery and guiding its management. The findings may inform clinical prognosis and suggest potential targets for clinical trials, including post-acute pain and loneliness, to reduce persisting symptoms after concussion.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern.","authors":"","doi":"10.1177/08977151251364787","DOIUrl":"https://doi.org/10.1177/08977151251364787","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Mediators Related to Vascular Dysfunction are Linked to ICP, PRx, and CPP Following Human Severe Traumatic Brain Injury.","authors":"Claudia Ann Smith, Caroline Lindblad, Edward Needham, Erta Beqiri, Sofia Bergström, Peter Smielewski, Peter Nilsson, Eric Thelin, Adel Helmy","doi":"10.1177/08977151251363979","DOIUrl":"https://doi.org/10.1177/08977151251363979","url":null,"abstract":"<p><p>Disturbed cerebral autoregulation (represented by a positive pressure reactivity index [PRx]), elevated intracranial pressure (ICP), and decreased cerebral perfusion pressure (CPP) are key treatment targets following severe traumatic brain injury (sTBI). This study investigated neuroinflammation as a potential mechanism underlying these intracranial disturbances. Plasma samples from 11 sTBI patients (from a prior Phase II drug trial) were analyzed for 174 proteins using an antibody-based suspension bead array, with intervention effects accounted for where possible. Dimensionality reduction techniques, including principal component analysis (PCA) and supervised methods, were applied to protein data, informed by physiological variables (ICP, CPP, and PRx). PCA revealed distinct protein clustering patterns related to ICP >20 mmHg and PRx > 0, with PC1 linked to patient ID, time from injury, and intervention, and PC2/PC3 significantly associated with PRx dose (<i>p</i> < 0.001). Markers relating to inflammation of the vascular system comprised 20% of the top 50 proteins influencing PC2, implicating complement inflammation in these processes. Notably, MASP-2 (<i>p</i> = 0.027) and complement factor I (<i>p</i> = 0.039) were significantly associated with PRx dose in a mixed-effects model. These findings suggest that vascular inflammation, particularly complement activation, may contribute to intracranial physiological disturbances in sTBI, highlighting the complement pathway as a potential target for further investigation.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Mild Traumatic Brain Injury in Older Adults: Recovery Course and Insights on Early Predictors of Outcome.","authors":"Xiaoxia Liu, Chongjie Zhang","doi":"10.1089/neu.2025.0032","DOIUrl":"https://doi.org/10.1089/neu.2025.0032","url":null,"abstract":"","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nomogram Predicts the Risk Factors for Post-Traumatic Cerebral Infarction in Polytrauma Patients with Traumatic Brain Injury.","authors":"Jianye Miao, Xin Qian, Zhenjun Miao, Jiayi Li, Litao Zhang, Renguang Zhang, Xianjun Ma, Yousef Rastegar-Kashkooli, Lang Liu, Nan Li, Qian Bai, Jiewen Zhang, Chao Jiang, Simeng Gu, Jian Wang, Junmin Wang","doi":"10.1089/neu.2024.0511","DOIUrl":"10.1089/neu.2024.0511","url":null,"abstract":"<p><p>Post-traumatic cerebral infarction (PTCI) is a significant complication in polytrauma patients with traumatic brain injury (TBI). Identifying high-risk patients for early intervention is crucial. This study aims to investigate the independent risk factors for PTCI in polytrauma patients with TBI to establish and validate a prediction model. A retrospective analysis was conducted on 511 patients with TBI and multiple injuries admitted between January 2016 and July 2023. The patients were divided into groups based on whether they developed PTCI. Independent risk factors for PTCI were identified using univariable, Lasso, and multivariable logistic regression analysis. A nomogram was established to predict the risk factors for PTCI. The receiver operating characteristic (ROC) area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were used to determine the predictive accuracy, discrimination, and clinical effectiveness of the nomogram, respectively. In addition, the Hosmer-Lemeshow test was used to assess the goodness-of-fit. Clinically significant associations were observed between PTCI and factors such as cerebral hernia, traumatic subarachnoid hemorrhage, basilar skull fracture, shock index, platelets, platelet-lymphocyte ratio (PLR), prothrombin time, international normalized ratio, D-dimer, albumin, injury severity score, and Glasgow coma score (all <i>p</i> < 0.05). These variables screened by Lasso regression were incorporated in multivariate logistic regression. They identified cerebral hernia, basilar skull fracture, PLR, D-dimer, and albumin as independent risk factors for PTCI (all <i>p</i> < 0.05). The analysis results were visually represented using a nomogram. The AUC of the prediction cohort was 0.9 [95% confidence interval (95% confidence intercal (CI)): 0.84, 0.97], and of the validation cohort was 0.87 (95% CI: 0.79, 0.96). The nomogram prediction model demonstrates excellent performance according to the ROC, calibration curve, and DCA, providing valuable insights for the early identification of high-risk PTCI patients.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1371-1381"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery Trajectories of Patients with Mild Traumatic Brain Injury.","authors":"Skye King, Ieke Winkens, Melloney Wijenberg, Jan Schepers, Sven Stapert, Jeanine Verbunt, Marleen Rijkeboer, Joukje van der Naalt, Caroline van Heugten","doi":"10.1089/neu.2024.0610","DOIUrl":"10.1089/neu.2024.0610","url":null,"abstract":"<p><p>Within the mild traumatic brain injury (mTBI) population, there is heterogeneity both in symptom presentation and recovery patterns. Components of the fear-avoidance model (FAM) may be useful in understanding this heterogeneity. This longitudinal study aimed to identify latent trajectory classes of postconcussion symptoms (PCS) and evaluate how these classes differ on components of the FAM, following mTBI compared with controls. Participants included 185 patients with mTBI and 180 patients with orthopedic injury. PCS, catastrophizing, activity avoidance, somatic focus, depression, participation restrictions and satisfaction were measured 2 weeks, 3, 6, and 12 months post-injury. Multivariate latent class growth analysis identified classes of participants with similar longitudinal trajectories on three variables: cognitive, emotion, and somatic symptoms. Demographic and injury characteristics were used to predict class membership. Class membership was used to predict FAM outcomes. In the mTBI group, Class 1 (C1, 5.9%) had very high maintained symptoms. Class 2 (C2, 20.5%) had high decreasing symptoms. Class 3 (C3, 19.5%) had moderate decreasing symptoms. Class 4 (C4, 54%) experienced low decreasing symptoms. Belonging to class 1 or 2 predicted worse outcomes, including higher catastrophizing, activity avoidance, depression, and participation dissatisfaction. In the control group, two classes were found. Findings highlight the heterogeneity within the mTBI population and the universal disabling impact of person-related behavioral characteristics across medical conditions. Persistent symptoms management and education after mTBI should target those with higher emotion and somatic symptoms, catastrophizing, and depression at 2 weeks post-injury. Interventions targeting catastrophizing, avoidance behaviors, and emotional health may assist in recovery.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1345-1358"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigation of Acute Seizures and Neuropathology after Traumatic Brain Injury by Structure-Based Discovery-Identified Drugs.","authors":"Natallie Kajevu, Ivette Banuelos, Pedro Andrade, Elina Hämäläinen, Laureano Sabatier, Manuel Couyoupetrou, María Luisa Villalba, Luciana Gavernet, Anssi Lipponen, Teemu Natunen, Noora Puhakka, Mikko Hiltunen, Alan Talevi, Asla Pitkänen","doi":"10.1089/neu.2024.0070","DOIUrl":"10.1089/neu.2024.0070","url":null,"abstract":"<p><p>Our objective was to test the hypothesis that structure-based identified or designed compounds exhibiting neuroprotective, antioxidant, and anti-inflammatory properties <i>in vitro</i> will mitigate early seizures and neuropathology after traumatic brain injury (TBI) <i>in vivo</i>. The neuroprotective and anti-inflammatory effects of 11 compounds identified by computer-assisted approximations were tested <i>in vitro</i> in neuronal microglial co-cultures. Among these, compound FBA exhibited the best neuroprotective (MAP-2, microtubule-associated-protein 2, a neuronal damage biomarker), antioxidative (nitrite production), and anti-inflammatory effects <i>in vitro</i> (all <i>p</i> < 0.01). Consequently, its neuroprotective and antiseizure effects were assessed <i>in vivo</i> in adult male Sprague-Dawley rats exposed to severe lateral fluid-percussion-induced TBI. Rats under continuous video-electroencephalogram monitoring received prophylactic treatment with an intraperitoneal (i.p.) injection of FBA (FBApro, 30 mg/kg) or vehicle (VEH, 48% PEG in 0.9% saline, 3 mL/kg) at 2 and 24 h post-TBI. Rats that developed status epilepticus received 1-2 additional on-demand FBA doses (FBApro+, 100 mg/kg, i.p.) to stop epileptiform activity. FBApro treatment reduced the cortical lesion area (18.9 ± 4.1 mm², <i>n</i> = 7) compared with VEH treatment (24.8 ± 5.7 mm², <i>n</i> = 10, <i>p</i> < 0.05). FBApro treatment also showed a favorable effect on the white matter by reducing plasma levels of pNF-H, a biomarker of axonal injury, compared with VEH treatment (Cohen's delta 0.657). Both FBApro (368 ± 407 s) and FBApro+ (256 ± 327 s) treatments reduced the average cumulative seizure duration compared with VEH (896 ± 703 s, both <i>p</i> < 0.05). The FBApro+ treatment regimen also reduced the mean relative theta and alpha power and increased the mean relative gamma power in the electroencephalogram (<i>p</i> < 0.05). Our data identified FBA as a novel structure-based discovered compound with promising favorable effects on structural and functional recovery after TBI.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1433-1452"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Participation after Mild Traumatic Brain Injury in Comparison to Orthopedic Trauma Controls: Results from a Longitudinal Multicenter Observational Cohort Study.","authors":"Jolein Manders, Melloney Wijenberg, Skye King, Sven Stapert, Jeanine Verbunt, Caroline van Heugten","doi":"10.1089/neu.2024.0413","DOIUrl":"10.1089/neu.2024.0413","url":null,"abstract":"<p><p>A subgroup of patients shows incomplete recovery after mild traumatic brain injury (mTBI). Outcomes are commonly measured on the level of symptoms or functional recovery. An alternative way to study outcome after mTBI is to measure the level of participation. The objectives of this study were to examine (1) the level of participation in patients with mTBI at 12 months post-injury in comparison to a non-head injury orthopedic trauma control group; (2) the relationship between the outcome domains participation, functional outcome, and post-concussion symptoms. A prospective, longitudinal, multicenter cohort study was conducted. Participants were 140 adults with mTBI and 144 adults with minor (non-head) orthopedic injury. The following outcomes were measured: participation (Utrecht Scale for Evaluation and Rehabilitation-Participation: USER-P), functional outcome (Glasgow Outcome Scale Extended: (GOS-E), and post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire: RPQ). Adults with mTBI have a significantly lower objective participation level (USER-P Frequency scale) than controls. No differences were found between the groups on subjective participation (USER-P Restrictions and Satisfaction scales) nor on functional outcome (GOS-E). Fifty-three people with mTBI (38%) had a score of ≥2 on ≥3 items, while 26 (19%) had an unfavorable USER-P outcome (≥2 restrictions) and only 9 (6.5%) had an unfavorable GOS-E score (<7). In both groups, the presence of persistent symptoms led to a significantly unfavorable outcome on both the USER-P and GOS-E. Participation frequency is lower in mTBI than in orthopedic controls, mainly determined by a significantly lower number of hours of (un)paid work, education, and/or household activities. People with mTBI more often report post-concussion symptoms, but functional recovery is not different between the groups. Participation seems to better represent incomplete recovery than functional outcome, but future research should confirm these findings.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1394-1403"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Brain Injury Diagnostic Interview: Development, Interrater Reliability, and 2-Week Post-Injury Clinical Profiles.","authors":"Mary U Simons, Alyssa Maio, Daniel L Huber, John D Corrigan, Nancy Temkin, Marin Darsie, Ryan Kitagawa, John Whyte, Joseph T Giacino, Murray B Stein, Geoffrey T Manley, Michael A McCrea, Lindsay D Nelson","doi":"10.1089/neu.2024.0402","DOIUrl":"10.1089/neu.2024.0402","url":null,"abstract":"<p><p>Because most traumatic brain injuries (TBIs) do not present with objective indicators (e.g., neuroimaging findings) to confirm the diagnosis, clinicians often rely on self- or observer-reporting of alteration of consciousness (AOC; e.g., loss of consciousness [LOC], amnesia, other signs of altered mental status), and symptoms to make diagnoses. Moreover, there is no universal agreement on signs and symptoms to sufficiently diagnose TBI, which leads to variability and ambiguity in how TBI is diagnosed in clinical and research settings. The lack of standardized procedures for the diagnosis of acute TBI is a major challenge that hampers the ability to evaluate and compare TBI studies and advance the science and treatment of TBI. We present a new semi-structured TBI Diagnostic Interview (TBI-DI), developed for prospective TBI research to collect injury information important to verifying eligibility for the diagnosis of TBI. Specifically, the TBI-DI collects patient (and/or witness) reports of head trauma, AOC (including LOC and amnesia), and TBI-related symptomology. We describe the protocol, interrater reliability of the TBI-DI items to the same audio-recorded interview, and observed injury characteristics for interviews conducted at 2 weeks post-injury. The sample comprised 335 interviews (320 self-reported, 10 informant-reported, and 5 both) collected on individuals with TBI who were prospectively recruited from 4 U.S. level 1 trauma centers from 2019 to 2023. Cohen's kappa was calculated to summarize interrater reliability <i>n</i> = 288 interviews. UpSet plots were created to illustrate the prevalence of distinct profiles of signs of AOC and symptom reporting. Overall, there was a near-perfect agreement between raters for all AOC descriptors (<i>κ</i> = 0.85-0.92) and symptom items (<i>κ</i> ranging from 0.92 to 0.99). We observed diverse profiles of AOC, with 45% manifesting witnessed LOC, post-traumatic amnesia, or other altered mental status. Patients (<i>n</i> = 325) self-reported 256 different combinations of the 14 acute symptoms included in the interview (most commonly experiencing headache, dizziness, fatigue, and difficulty concentrating). The TBI-DI and associated SOP appear well-suited for use in a multicenter prospective study of TBI. Future research should examine the stability of reporting by respondents and the alignment between interview and objective clinical information. The TBI-DI solicits diverse acute diagnostic information that, when combined with clinical information (including confounding factors) and objective injury indicators, may inform more rigorous scientific reporting and evidence-based TBI diagnostic practices.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1404-1415"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Mental Health Complications Following Mild Traumatic Brain Injury.","authors":"Shuyuan Shi, Ana Mikolić, Joelle LeMoult, Jason Rights, William J Panenka, Noah D Silverberg","doi":"10.1089/neu.2024.0505","DOIUrl":"10.1089/neu.2024.0505","url":null,"abstract":"<p><p>Prognostic models can support prevention of mental health complications after mild traumatic brain injury (mTBI). The present study aimed to identify risk factors and develop prognostic model(s) for mental health complications following mTBI. This secondary analysis of data from a randomized controlled trial included 513 adults presenting to emergency departments/urgent care centers. Candidate predictors were demographic, injury-related and health history information collected during medical chart review and eligibility screening, and scores on questionnaires completed at 2 weeks postinjury. The primary outcome was presence/absence of new or worsened major depressive disorder, anxiety disorders, and post-traumatic stress disorder (PTSD), determined with a structured psychodiagnostic interview (Mini International Neuropsychiatric Interview) at 3 and 6 months after mTBI. Logistic regression assessed the prognostic value of 22 pre-, peri-, and early postinjury factors. Least absolute shrinkage and selection operator (LASSO) was used to select predictors in prognostic model development. Younger age, identifying as a person of color, prior mTBI(s), maladaptive illness perceptions, and greater PTSD, and depression and anxiety symptom severity measured at 2 weeks postinjury were significant predictors of new/worsened mental health complications 3-6 months following mTBI. A comprehensive model (with 9 LASSO-selected predictors) showed strong discriminability for predicting mental health complications (optimism-corrected area under the receiver operating characteristic curve [AUC] = 0.80), outperforming a basic model that included only variables commonly collected as part of usual clinical care (optimism-corrected AUC = 0.71). Certain pre-injury and demographic characteristics are associated with increased risk of mental health complications after mTBI. Assessing for early postinjury illness beliefs and psychological symptoms can further improve prognostic accuracy.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":"1359-1370"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}